| NPI | 1205541000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY DODSON Manager 985-774-4076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2023-01-17 |
| Last Update Date | 2024-07-18 |